Facial skeletal surgery in the management of adult obstructive sleep apnea syndrome.

Obstructive sleep apnea (OSA) remains a significant public health problem because of its neurocognitive sequelae. Additionally, with persistent obstruction, it has an impact on the cardiovascular system, leading to hypertension and cardiac failure as one of its causative or comorbid factors. For the surgeon managing OSA, there is a stepwise sequence of surgical procedures, from improving nasal airflow to facial skeletal maxillary-mandibular advancement, with the cumulative goal of volumetrically increasing the retropharyngeal airway space. Familiarity with conventional orthognathic principles is essential in achieving this goal.